Immunosuppressant Drugs Comparable in Noninfectious Ocular Inflammation

Looking Through a Retinal Camera
A senior woman looking through a retinal camera at an optometry office during an eye exam.
Researchers reviewed the use of mycophenolate mofetil and methotrexate in cases of noninfectious ocular inflammatory disease.

This article is part of Ophthalmology Advisor’s Focus on Retina coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the retinal experts at the AAO. Check back for more from the AAO 2021 Meeting.


Mycophenolate mofetil (MMF) and methotrexate (MTX) are comparable in their ability to treat noninfectious ocular inflammatory disease (NIOID), according to study results presented at the American Academy of Ophthalmology (AAO) 2021 Annual Meeting. Abdulmalik Alsaif, MBChB, explained the systematic review and meta-analysis on the 2 immunosuppressant drugs.

The research consisted of a database search for studies comparing MMF with MTX in NIOID. A meta-analysis of the 4 studies applied found no significant differences in primary outcomes between the medications: Overall treatment success (OR=0.97; P =.96) and failure (OR=0.86; P =.85). In addition, treatment success showed no significant difference for anterior and intermediate uveitis cases (OR=2.33; P =.14). There were some differences between the immunosuppressant drugs in the studies reviewed, however: “MTX showed significantly improved effect in posterior uveitis and panuveitis (OR=0.41; P =.003). The median dose required for treatment success was lower for MTX, but MMF had a faster median time to treatment success. Furthermore, less side effects were noted in MMF, but without statistical significance,” according to the researcher. 

No significant difference was found for secondary outcomes in visual acuity and resolution of macular edema

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Alsaif A. Mycophenolate mofetil vs methotrexate in noninfectious ocular inflammatory disease: a systematic review and meta-analysis. Poster presented at: The American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract PO390.